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									Cheshire Health and Social Care
Single Assessment Process
                                             Agenda
                    The Single Assessment Process
                    The Cheshire Project
Alan Allman
                    Timescales
Cheshire eSAP       Why Choose MDS?
Programme Manager   Documentation
                    Information Sharing
                    SAP Groups
                    Project Team
                    CSAP and Strategy
                    CSAP Concepts
                    Training
                    Achievements
                    Questions, Costs and Demo
The Single Assessment process
   Published by the Department of Health in
    February 2001
   Made reference to the need to move towards
    more integrated, “person centred” care in the
    NHS and Social Care
   Recommended that a single joint assessment
    process with agreed high standards would
    assist this
   Authorities ratings are impacted by the
    effectiveness of their care, implementation of
    the Single Assessment Process has an impact
    on that effectiveness
NOT the Single Assessment
        Process...
The Cheshire Project
          Cheshire locality: two years of work to
          investigate best tools & solutions, agreed
          on the use of an electronic MDS-HC
          assessment protocol to support the Single
          Assessment Process across all Cheshire
          agencies.
          MDS-HC is one of a small number of
          protocols accredited by the Department of
          Health
          Contract awarded to IBM to deliver an
          electronic version of Single Assessment
          Process
          Contract signature – June 2005
          Enterprise Award – University of Kent:
          Runner-up, best Collaboration
          Go-live - 31 February 2006
    Timescales and Events
 2002 – 2003 Evaluation of Tools (Paper / Electronic)
 2003 Decision to use MDS

 2003 Agreement by PCT’s and Social Services to
  purchase an electronic version of MDS
 2004 SHA Approval

 2004 Setup of multi agency SAP Board

 2004 ITT and Selection

 2005 (June) Contract signed

 2005 Development and agreements

 2006 Go live
     Why did we choose MDS?
   Assessments at ALL required levels: Contact,
    Overview, Specialist, Comprehensive.
   Research validated scales, and quality indicators,
    are used to inform clinical practice and outcome
    monitoring.
   Also may be aggregated for service monitoring
    and planning.
   Links between assessment and further action,
    including best practice in care planning.
        Background to MDS
           Assessment
   Work began in 1993 on v1
   Complementary tools for care homes & community
    care
   International Involvement
      19 different countries

   Support in UK through
      Centre for Health Services Studies

      University of Kent at Canterbury

   Revised UK version for SAP published October
    2003
Assessment components
   Identification            Communication/          Health Conditions and
    Information                hearing                  Preventative Health
                               Patterns                 Measures
   Personal Details
                              Vision Patterns         Nutrition/hydration
   Referral Items            Mood and                 status
   Background                 Behaviour               Dental Status (oral
    Assessment                 Patterns                 health)
    Information – eg          Social                  Skin Condition
                               functioning
    Carer/Objectives/G                                 Environmental
                              Informal                 Assessment
    oals                       Support
                               Services                Service Utilisation
   Cognitive Patterns
                               Physical                Medication
   Physical             
                                                        Triggered Client
                               Functioning          
    Functioning                                         Assessment Protocols
                              Continence
    Assessor                                            (CAPS)
                             Disease
    Information                Diagnosis
   Other Carer
    Information
        Contact

                   Overview

                                   Comprehensive
              Documents
   Memorandum of                Technical
    Understanding                 Architecture
   Roles and                    Security Strategy
    Responsibilities             Risk Log
   Information Sharing          Issue Log
    Agreement
                                 Test Strategy
   Caldicott Agreement
                                 Requirements
   Training Strategy             Specification
   Implementation Strategy
   Import/Export Strategy
The Information Sharing
Toolkit (IST)
  Tier 1: Framework Document (Strategic)
• Tier 2: Information Sharing Arrangement (Operational)
• Tier 3: Operational Instruction (Practitioner)
• Tier 4: Privacy, Confidentiality & Consent (Service User)
This structure is designed to ensure that each element
involved in the gathering and sharing of personal identifiable
information is properly considered; it is not hierarchical.


     All underpinned by a Caldicott Agreement
                             SAP Groups
                      PCT Boards                   Elected Members

 Cluster Expert Ref Group                                      Strategic Health ICT Board



       ADSS IMG                       SAP Board                 PCT/Acute IMT Boards



Cheshire & Merseyside SAP          SAP Leads Group            County IT Strategy Group
           Group


                                    SAP Project Team
    SAP Project Team
Alan Allman – SAP Health and Social Care Programme
Manager

Hazel Wright – SAP Consultant

Alan Wright - Cheshire SAP Project Manager

Lesley Bull – East Cheshire Project Lead (NHS)

Chris Douglas – Central Cheshire Project Lead (NHS)

Kate Bebe – West Cheshire Project Lead (NHS)


Each Organisation Provides One ICT Lead Contact
                                        Priority
                                        Other Projects
                                                                                     Partnership Developer
               Organisational
 Business                               Timescales                                                                              Alan Allman
                   Need
Requirement
                                                               Capital Funding
  Process
                                                               Revenue
                                 Organisational                Costs
 Single
 Process      Agreements            Funding
                                                                                     Security
 Client
                                                                                     Standards
 Benefit      MoU                                     Organisational
                                                                                     Political
 What         Caldicott                                   Policy
 can we
                                 Protocols                                                                Terminology
              Roles and
 stop                                                                                                     Statutory Reporting
              Responsibilities
 doing
                                                                           Organisational                 Other systems
              Support            Data Sharing
 Reqmts
              Framework                                                     Operations
 Spec                            Security
                                                   Governance                                                               Competing
                                 Strategy                                                                                   Demands
 Organistnl
 Benefit
                                                      Multi                                      Organisational
                                                      Agency          Implementation               Pressures
                                                      Board              Planning                                                             Human
                                                      IT Boards
                                                                                                                                              Finance
                                                                                                                     Organisational
                                                                          Project Plan
                                                     Test Strategy                                                    Resources               Equipment
                                                                          Resource
                                                                                                 Training
                                                                          Plan
                                                       Interfaces
                                                                          Training               Data P                                   Evaluation
                                                                          Plan
                                                   Infrastructure                                Steady
                                                                                                                                          Help Desk
                                                                          Support                State              Implement
                                                                          Plan                   Training                                 End Old
                                                                          Contingency            Expert                                   Processes
                                                                                                 Users

                                                                  Review
The CSAP system will link together 1 Local
      Authority and 8 NHS Trusts
   Used in: Acute Hospitals, Community Hospitals, GP Surgeries, Patient Homes via Mobile Devices,
            Social Services Departments, Clinics




         System Administrator        Read Only Users                 Assessors
     Manage Relationships
     View Audit log          Notifications  Register / Logon /        Read only functions +…
     Maintain Data Integrity                Self-care                 Perform Assessments
     Approve Registrations                  Search                    Handle Delayed Discharge



                                  Electronic Single                          Existing
     Demographics                   Assessment                              Health and
       Systems                        Process                               Social Care
                                      System                                Application
    NPfIT Spine PDS
    Or Exeter                                               Notifications
            IBM is providing a fully
              managed service
                           NHSne                  Council
Health Workers              t / N3                Intranet      Social Care Workers



                                                                       Other e.g. Housing, Voluntary
                                      Internet
     Mobile Working

                                                             Existing Health
Scope of IBM Supply                                          and Social Care
                                                               Applications
                                Esprit ShareCare

                              Existing Cheshire
                                    service
     Second Level                                                VPN            Demographics
      Helpdesk                                                                    Systems
                              eSAP
                              MDS
                                                                               NPfIT Spine PDS
                                                                               Or Exeter
      Third Level
       Support        IBM eBusiness Hosting Warwick
 SAP: A process-orientated solution to support a virtual
 multi-agency Health & Social Care Community


                                        Key Requirements:
            Adult Care                  • Simple & easy to use
                                          assessment tool for
               &                          Professionals
Health        SAP        Social         • Strong Data Security

  &                       Care          • Caldicott Compliance
         Children’s Care   &            • Ability to Interface
 NPfIT                                    effectively
                &        ESCR           • Availability & Resilience
               ICS                      • Best Value




      Health & Social Care Community
SAP Concepts
Assessment Episode
A group of Assessments for a person (Items) currently open


Assessment Item
The type of Assessments open (Overview / Specialists etc)


Assessment Action
Actions assigned for professionals to undertake
SAP Concepts
                                    Assessment
                                 Item (eg Specialist)


                                    Assessment
                                  Action (Section G)
 Assessment
   Episode                          Assessment
       Assessment                 Action (Section H)
    Item (eg Overview)
                     Assessment
              Action (Section A,B,C Etc)


                                                 Assessment
                                                  Completed
     Training – Face to Face &
                CBT
   40 Expert Users across Health
    and Social Care, DP Experts, IT
    Trainers

        Cascade Training
        Data Protection Training
        Basic IT Training
        MDS Protocol Training

   CBT Course

        All users have access
        Q&A throughout the course
     Computer-based Training
    (CBT) – a key differentiator
   Product specifically designed for the
    UK
      Context of SAP, UK consent
        practice fully covered
   Designed as a CBT:
      Addresses standards from
        TOPPs, uses SCORM, eGIF etc
      High quality presentation
        engages users
      Integrated Q&A with additional
        info retains users’ attention
      Management get progress
        statistics (accessible via
        reporting tool)
Introducing one of the domains…




                   Navigation to other domains
            Achievements
   Single Agreement across      Delivered to
    Health and Social Care        Budget
   Defined Roles and            Only a 3 Week
    Responsibilities              Delay in Delivery
   Joint Information            Lead Cluster SAP
    Sharing Agreement             Process Group
   Caldicott Agreement          Do Once and
   Joint Programme Board         Share Core Group
   Multi Agency Training        34 Organisation
                                  interested
Questions & Demo

How Much?
Application, License, CBT Course, 40 Expert Users Trained,
Hosting Setup, Hosting and Support Services for 3 Years
= £793,000

Staffing Costs
Project Staff for SAP Across Health & Social Care
= £250,000 year 1 - £200,000 years 2 & 3

								
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